title: Outbreak-related mumps vaccine effectiveness among a cohort of children and of young adults in Germany 2011.
abstract: Mumps outbreaks in populations with high 2-dose vaccination coverage and among young adults are increasingly reported. However, data on the duration of vaccine-induced protection conferred by mumps vaccines are scarce. As part of a supra-regional outbreak in Germany 2010/11, we conducted two retrospective cohort studies in a primary school and among adult ice hockey teams to determine mumps vaccine effectiveness (VE). Via questionnaires we collected information on demography, clinical manifestations, and reviewed vaccination cards. We estimated VE as 1-RR, RR being the rate ratio of disease among two-times or one-time mumps-vaccinated compared with unvaccinated persons. The response rate was 92.6% (100/108--children cohort) and 91.7% (44/48--adult cohort). Fourteen cases were identified in the children and 6 in the adult cohort. In the children cohort (mean age: 9 y), 2-dose VE was 91.9% (95% CI 81.0-96.5%). In the adult cohort (mean age: 26 y), no cases occurred among the 13 2-times vaccinated, while 1-dose VE was 50.0% (95% CI -9.4-87.1%). Average time since last vaccination showed no significant difference for cases and non-cases, but cases were younger at age of last mumps vaccination (children cohort: 2 vs. 3 y, P=0.04; adult cohort: 1 vs. 4 y, P=0.03). We did not observe signs of waning immunity in the children cohort. Due to the small sample size VE in the adult cohort should be interpreted with caution. Given the estimated VE, very high 2-dose vaccination coverage is required to prevent future outbreaks. Intervention efforts to increase coverage must especially target young adults who received<2 vaccinations during childhood.
authors.affiliation: Immunization Unit; Robert Koch Institute; Berlin, Germany; Postgraduate Training for Applied Epidemiology (PAE); Robert Koch Institute; Berlin, Germany; European Programme for Intervention Epidemiology Training (EPIET); European Centre for Disease Prevention and Control; Stockholm, Sweden.
authors.forename: Anja
authors.initials: A
authors.lastname: Takla
authors.affiliation: Postgraduate Training for Applied Epidemiology (PAE); Robert Koch Institute; Berlin, Germany; European Programme for Intervention Epidemiology Training (EPIET); European Centre for Disease Prevention and Control; Stockholm, Sweden; Bavarian Health and Food Safety Authority (LGL); Institute for Health; Oberschleißheim, Germany.
authors.forename: Merle M
authors.initials: MM
authors.lastname: Böhmer
authors.affiliation: Bavarian Health and Food Safety Authority (LGL); Institute for Health; Oberschleißheim, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Klinc
authors.affiliation: Public Health Authorities-City of Nuremberg; Nuremberg, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Kurz
authors.affiliation: Public Health Authorities-City of Nuremberg; Nuremberg, Germany.
authors.forename: Alice
authors.initials: A
authors.lastname: Schaffer
authors.affiliation: Public Health Authorities-District of Erding; Erding, Germany.
authors.forename: Heribert
authors.initials: H
authors.lastname: Stich
authors.affiliation: Bavarian Health and Food Safety Authority (LGL); Institute for Health; Oberschleißheim, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Stöcker
authors.affiliation: Immunization Unit; Robert Koch Institute; Berlin, Germany.
authors.forename: Ole
authors.initials: O
authors.lastname: Wichmann
authors.affiliation: Immunization Unit; Robert Koch Institute; Berlin, Germany.
authors.forename: Judith
authors.initials: J
authors.lastname: Koch
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D004196:Disease Outbreaks; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009107:Mumps / Q000453:epidemiology* / Q000517:prevention & control*; D009108:Mumps Vaccine / Q000008:administration & dosage*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D064166:Vaccine Potency; D055815:Young Adult
chemical_list: D009108:Mumps Vaccine
keywords: Germany; MMR vaccine; adults; cohort study; mumps; vaccine effectiveness